Responding to the challenge of "feminisation" of AIDS

The laws guaranteeing equality are in place, the anti-AIDS information is out there, the girls are going to school in ever greater numbers, and yet young women in Southern Africa are becoming infected with HIV at an alarming rate. In South Africa, Zambia and Zimbabwe, more than 75 percent of HIV-positive youth aged 15 to 24 are female. HIV prevalence rates among pregnant women average 25 percent in the region, but remain below 15 percent in East Africa and under 10 percent in West Africa. This crisis has been examined in 'Facing the Future Together', a recently published report by the UN Secretary-General's Task Force on Women, Girls and HIV/AIDS in Southern Africa. The report, compiled by top feminists and women advocates in the region, explores the link between gender and HIV/AIDS, and suggests some practical responses. In a departure from the orthodox "practice abstinence" approach, the report points out that the ABC strategy - abstain, be faithful and use a condom - does not fit the particular needs of women and girls. "The messages have been missing the mark," the report said. One reason is the "not only widespread, but widely accepted and endorsed" prevalence of rape and sexual violence. In the context of men growing up believing masculinity means having plenty of sexual partners, being faithful to your husband does not prevent infection. Using a condom requires a willing partner, and in a region where one in five women has been physically abused, fear can undermine an insistence on protection, the task force noted. Poverty drives girls and women into exchanging sex for goods, gifts, food, bus fare or school fees. As a result, young women tend to have sexual partners who are 5 to 10 years older, and more likely to be infected with HIV. A study in Zambia found that 18 percent of girls tested HIV-positive within a year of losing their virginity, said the report. Keeping girls in schools helps them delay sex, but only if they are not having forced sex with teachers and students. Governments, schools, communities and parents need to work together to make schools a safe place for girls, with zero tolerance for teachers who sexually harass students, urged the report. Southern Africa has Africa's highest school enrolment for girls, but poverty and AIDS were making girls drop out in ever-growing numbers. To help keep girls in school, school fees should be abolished, as Zambia boldly did recently, and the cost of text books and uniforms kept to a minimum, the report recommended. Dispossession of land, home and property often follows the death of a husband, partner or parent. Southern African countries have signed international agreements and passed laws guaranteeing equality among men and women, but many obstacles stand in the way of implementation. One problem is the co-existence of customary and modern law. Fear of violent reprisals, accusations of being a traitor to tradition and culture, have stopped many women from complaining. Those who seek redress can face sluggish bureaucracies, official indifference, complex land administration systems and insensitive officials, the task force found. The report suggested training community-based paralegals, working with traditional leaders to resolve discrepancies between the two legal systems, training police and judicial officials, and including information on property and inheritance rights in high school curricula. Surprisingly, women in Southern Africa have more access than men to antiretroviral (ARV) treatment, which slows the progression of the HI virus, because most referrals for ARV come from antenatal clinics. But many women still do not get tested or treated, afraid of rejection by their husband or family if they disclose their HIV-positive status. Counsellors should know how to deal with issues of violence, partner notification and confidentiality, while policies barring young people from counselling and testing must be revised, stressed the report. The task force, established in 2003, comprised parliamentarians, health ministers, religious leaders, educators, academics, women living with HIV/AIDS, women's rights activists and lawyers. It examined the situation in Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe. View the report www.sarpn.org.za